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Babikow Greenhouses 7838 Babikow Road Baltimore, Maryland 21237 410-391-4200 Fax 410-574-7582 Toll Free 800-835-7617 Email:

Customer Information Form F orm

*Note: This form is NOT an application for credit* General Information Business Name:_____________________________________________________________________________________________ Street:______________________________________________________________________________________________________ City:____________________________________________________________ State:____________ Zip:______________________ Phone:_____________________________




Date business started:_____________

Federal Tax ID #:_________________________________


Shipping address (if different from above) Street:__________________________________________________________________ City:_______________________________County:_______________________________ State:________ Zip:_________________

Tax exempt status:  Not tax exempt (pay sales tax). (NOTE: We must charge sales tax unless we have a CURRENT copy of your sales tax exemption certificate ON FILE.)  Tax Exempt (do not pay sales tax). State exemption certificates attached for the following states:____________________________________ Please check business type below:  Corporation  Partnership  Sole Proprietor  Non-profit  Municipality  Limited Liability Company License number: __________________________________________________________ Please check business category below:  Landscape contractor  Municipality  Agricultural producer  Landscape architect  Interiorscaper  Garden center  Property maintenance  Florist  Irrigation contractor  Golf Course  General Contractor Other:_________________________________________________________________

Customer information form

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Babikow customer information p. 2

List officers / owners of company: Name and Title Address Phone Number 1.__________________________________________________________________________________________________________ 2.__________________________________________________________________________________________________________ 3.__________________________________________________________________________________________________________

Wholesale terms and conditions 1. This Form is not an application for credit. All new accounts will be COD. For your convenience we do accept VISA, MASTERCARD, DISCOVER, and AMERICAN EXPRESS. We would be pleased to extend credit to your company when you submit a credit application and we receive responses from your references. 2. Maryland sales tax of 6 % will be added to all orders unless we have your CURRENT Maryland Sales Tax Exemption certificate on file. Sales outside of Maryland: We must add the sales tax for the state where the order is delivered unless we have your State Sales Tax Exemption Certificate on file for that state. 3. Accounts presenting checks that are returned due to insufficient funds will be charged $25.00 per incident. 4. Babikow Greenhouses reserves the right to close a wholesale account under certain circumstances; for example, returned checks, nonpayment of invoices, grossly overdue payment, etc. By signing this form I hereby agree to all terms and policies of Babikow Greenhouses and agree to accept responsibility for all purchases made on this account and to pay any and all collection costs, including attorney fees and bank fees, should this account ever go into collections.

Authorized signature:____________________________________________________Date:_______________

Persons authorized to make purchases: Signature Print Name 1.__________________________________________________________________________________________________________ 2.__________________________________________________________________________________________________________ 3.__________________________________________________________________________________________________________ 4.__________________________________________________________________________________________________________

*Note: This form is NOT an application for credit*


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